Individual
MRS. NICOLE MARIE MCKENNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
307 S COURT ST, LAPEER, MI 48446-2514
(810) 667-6110
(810) 667-3562
Mailing address
4466 W BRISTOL RD, FLINT, MI 48507-3170
(810) 733-1200
(810) 733-3130
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601004179
MI
Other
Enumeration date
12/19/2006
Last updated
10/30/2023
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